Cost-utility analysis of the treatment of patients of the primary health network of Presidente Prudente-SP

Author(s)

Dayane Cristina Queiroz

• Document type: Master's Dissertation
• Press: Presidente Prudente. 2018-04-26.
• Institution: Universidade Estadual Paulista (Unesp). Faculdade de Ciências e Tecnologia. Presidente Prudente
• Defense date: 2018-03-23
• Advisor: Jamile Sanches Codogno

Abstract

The high index of chronic diseases has been directly associated with high costs related to health, directly influencing the reduction of quality of life. However, Brazilian studies that evaluate cost-utility through measures of quality of life and resources spent on health are still scarce in the literature. Thus, the objective of the study was to evaluate the cost-utility ratio of the treatment of patients in the primary health network of Presidente Prudente/SP. The sample consisted of 292 patients, of both sexes, aged 50 years or more. Patients were assessed for: i) quality of life; ii) QALY; iii) health costs; iv) level of physical activity; and v) use of medications. For statistical analysis, mean values, standard deviation, median, difference between quartile and percentage values were used for descriptive statistics, t-test for independent samples, Pearson's correlation for numerical variables and the chi-square test for categorical variables. For the cost-utility of the treatments, values of QALY and the mean cost / year for each treatment were used. Statistical significance (p-value) was set at values below 5%. The software used was BioEstat (version 5.0). There was a negative correlation between the physical activity domain in leisure and locomotion with additional consultations and costs (p-value <0.05), medication and total costs (p-value <0.01), and habitual physical activity with consultations, additional costs and total costs (p-value <0.01). Consultations, additional costs, medications and total cost were higher in patients who reported higher number of diseases (p-value = 0.001). The cost-utility of the treatment of primary care patients was higher in the drug treatment group, followed by the drug group linked to physical exercise that was cost-effective with a high QALY mean. Higher QOL scores were observed in males when compared to females. However, variables such as weight, BMI and presence of arterial hypertension were associated with lower QOL scores. In addition, data regarding hospitalizations and surgeries were analyzed impacting the QoL of the evaluated patients and, finally, costs associated with health services were also related to QoL. (AU)

• FAPESP's process: 16/12071-8 - Cost-utility of patient treatment attended by the public health system in Presidente Prudente-SP
• Grantee: Dayane Cristina Queiroz Correia
• Support Opportunities: Scholarships in Brazil - Master